Workers Compensation Settlements

July 8, 2022

When to Settle a PA Workers’ Compensation Case

Perhaps the most frequent question we, as attorneys who represent injured workers in PA workers’ compensation cases, receive is, “When can I settle my case?” Such a simple question for such a complicated issue. An entire page of our website is devoted to this “Big” question, as is part of the FAQs.

Initially, we should note that not every Pennsylvania workers’ compensation case ends in a settlement. Sometimes, the best interests of the injured worker do not result in such a conclusion to a case. This may be secondary to the injured worker having returned to the same employer after the injury (most workers’ comp cases require a resignation as part of the settlement), or it may be due to a substantial future medical exposure (which often has drastically different calculations between reasonable expectation and what the workers’ compensation insurance carrier would offer), or it may be some other issue unique to that particular case.

There is no “magic” time to settle a PA workers’ comp case. We have reached a settlement in a Claim Petition, mere months after an injury, and we have reached a settlement many years after an injury. Though it sounds like a cliché, it is true – every case is different and must be judged by its own facts and circumstance.

July 27, 2018

PA Workers’ Compensation Seminar – Continuing Education Series

by Glenn Neiman

Brilliant & Neiman LLC is proud to announce a Continuing Education Series, with topics of interest to the injured worker in Pennsylvania. The initial seminar in the series will take place on Tuesday, September 25, 2018 at 7:00 p.m., at the headquarters of the firm, 260 West Street Road in Warminster, PA.

The program on September 25, 2018 will be entitled “Settling a PA Workers’ Compensation Case – What the Injured Worker Has to Know.” We selected this topic to start the series, since we are often asked questions regarding the settlement of workers’ comp cases in Pennsylvania. Specifically, we will be discussing the timing of a settlement, the factors that go into determining the value of a PA workers’ compensation case (and the factors that, for reasons we will explain, do not), and the process (from the start of the settlement negotiations to the final approval of the Compromise & Release Agreement).

Additional programs will be held in October and November (for those marking their calendars, the dates will be October 24, 2018 and November 29, 2018). The program in October will examine and explain the PA workers’ compensation litigation process, from the origin of a claim, and the starting of benefits, through litigation when an insurance carrier seeks to reduce or end the benefits. We felt this topic would be helpful to address the stress an injured worker faces about the direction and future of his or her case. Finally, the November program will talk about the medical issues involved with an injured worker, specifically, as dealing with chronic pain. Depending on the level of interest, there could be additional programs added to this series.

November 3, 2017

Settling a PA Workers’ Compensation Case

by Glenn Neiman

One of the frequent questions we are asked is regarding the settlement of a Pennsylvania workers’ compensation claim. In fact, there is a page on our website just devoted to settlements. When considering whether to settle his or her case, there are several things an injured worker should consider. Initially, it is important to note that not every workers’ comp case settles. Workers’ compensation benefits can end for a variety of reasons, other than a settlement. Therefore, just because you have had a work injury in PA, do not believe you are simply entitled to a settlement.

The timing of the case is always an important consideration when considering whether to settle a case. We do not mean timing in a strict calendar sense, as there is no magic number of months or years which must go by before a case can settle. Instead, we are looking at the posture of the case. Is the injured worker still in active treatment? Is surgery, or other invasive treatment still being planned? Is there other health coverage available? As to the case legally, we ask whether there is a current threat to the benefits? Whether there is current litigation, and the chances of success? What is the employability of the injured worker? (Considering that encompasses both physical restrictions, as well as educational and work backgrounds). As you can see, there are many factors going into whether now is the right time to settle.

Next, the question may be the value of the case. Again, there is no magic formula. A settlement only works if both sides agree. It has to be voluntary for everyone. Unlike a personal injury case, there is no pain and suffering in a PA workers’ compensation case. A settlement purely reflects loss of earnings, and, if applicable, future medical treatment. Obviously, the settlement figure is something to be negotiated.

November 2, 2016

PA Workers’ Comp Case Can be Precluded by Time Limitations

by Glenn Neiman

In law, almost every cause of action has a “statute of limitations.” This is simply a time within which a cause of action can be brought. Typically, if a suit or action is not filed within the applicable statute of limitations, the suit or action will be dismissed. Pennsylvania workers’ compensation cases are no different. Basically, the statute of limitations for a PA workers’ compensation case is three years. But that is only part of the story.

There are actually time constraints in PA workers’ comp other than the basic statute of limitations. These can be longer or shorter than the general statute of limitations. For example, notice of an injury must be provided within 120 days of the injury (though, in certain types of cases, that time can be extended under the “discovery rule”). Unless the case is covered by the discovery rule, the failure of the injured worker to provide notice to the employer within 120 days of the injury will cause the workers’ compensation claim to be denied.

On the other hand, there are types of workers’ comp cases in PA that have a statute of limitations longer than three years. When an injured worker dies subsequent to an injury, as a result of the work injury, we have what is known as a “fatal claim.” Under the Pennsylvania Workers’ Compensation Act, as stated in Section 301(c)(1), ” . . . wherever death is mentioned as a cause for compensation under this act, it shall mean only death resulting from such injury and its resultant effects, and occurring within three hundred weeks after the injury.” So, as long as the death takes place within 300 weeks of the work injury, fatal claim benefits may be obtained (these provide benefits to dependents, since general workers’ compensation benefits in PA end with the death of the injured worker).

November 16, 2015

Mandatory Mediation Policy for Philadelphia Workers’ Compensation Judges’ Office

by Glenn Neiman

When litigation begins in a workers’ compensation case in Pennsylvania, by law, a “Mandatory Mediation” must be conducted (unless such a mediation would be “futile.”). The guidelines for these Mandatory Mediations can vary by the hearing office involved (generally, each county in Pennsylvania has a workers’ compensation hearing office).

Recently, the Philadelphia Workers’ Compensation Hearing Office issued a statement containing the policy of that office for Mandatory Mediations. By the law, the mediations will be scheduled in each case, unless the Workers’ Compensation Judge (WCJ) assigned to the case deems it futile. The date of the Mandatory Mediation will be determined with input from the attorneys on each case (as some cases require testimony or depositions to be completed before the parties are in a position to discuss settlement of a case). The policy makes clear that no continuances will be granted for Mandatory Mediations. If a Mandatory Mediation is cancelled, and the parties still wish to have a mediation done, the parties must approach another WCJ and schedule a Voluntary Mediation.

May 1, 2013

Brilliant & Neiman LLC Involved in Mediation Working Group with Bureau

by Brilliant & Neiman

Mediation is a growing area in Pennsylvania workers’ comp. As we have previously discussed, a mediation is when an independent party, in this context usually a Workers’ Compensation Judge [WCJ] (other than the assigned WCJ), meets with the parties in an informal setting in an effort to resolve the differences between the parties. The ultimate goal is to achieve a settlement to the case (usually done by “Compromise & Release Agreement”).

Since we at Brilliant & Neiman LLC work with injured workers every day, having constant contact with the Pennsylvania workers’ compensation system, we are well-versed in most aspects of how the system functions from day to day. We are proud that our knowledge and experience will be used by the PA Bureau of Workers’ Compensation, as the Bureau adjusts the system to change with the times.

Since the start of “Mandatory Mediation,” added to the Pennsylvania Workers’ Compensation Act in the 1996 amendments to the Act, the system has been relatively stagnant. Recently, the Bureau has sought a small working group to evaluate the mediation system and see what, if any, changes could be beneficial to the mediation process.

September 19, 2012

PA Workers Comp Settlement Cannot be Reopened For Medical Bill

by Glenn Neiman

Settling a workers’ compensation case in PA, generally referred to as a “Compromise & Release,” is a big decision. There are many factors which go into not only the value of the case, but whether settlement is even advisable. The advice of an attorney who is experienced with PA workers’ comp cases can be very valuable. This goes for the settlement itself, as well as the documents carrying out the settlement.

Recently, the Commonwealth Court of Pennsylvania decided the matter of Hoang v. Workers’ Compensation Appeal Board (Howmet Aluminum Casting, Inc.). In this case, the injured worker settled his case (by executing a Compromise & Release Agreement). Sometime after the settlement, the injured worker learned that his treating doctor had an outstanding bill for over $37,000.00.

An appeal of the Compromise & Release Agreement could not be filed (since one only has 20 days to file such an appeal), so the injured worker filed Review and Penalty Petitions, seeking payment of this medical bill. The Workers’ Compensation Judge (WCJ) noted that the Compromise & Release Agreement failed to state that the workers’ compensation insurance carrier would be responsible for any medical bills. Since this is a somewhat common statement in a PA workers’ comp settlement, the WCJ called this “telling.” The injured worker argued there was a “mutual mistake of fact,” so the settlement should be reopened. Ultimately, the WCJ denied the Petitions, finding that the workers’ compensation insurance carrier did not violate the Pennsylvania Workers’ Compensation Act because the Compromise & Release Agreement did not require payment of this bill. No mutual mistake of fact was seen by the WCJ. The decision was affirmed by the Workers’ Compensation Appeal Board (WCAB).

January 18, 2012

Workers’ Compensation Specialty Coming to Pennsylvania

by Glenn Neiman

As attorneys who limit their practice to representing the injured worker in PA workers’ comp cases, we are thrilled by the recent announcement that the Supreme Court of Pennsylvania has approved the process of creating a “certified workers’ compensation attorney” in Pennsylvania (or, in other words, a workers’ compensation specialist).

We have seen the damage done to cases when an injured worker trusts a general practitioner to handle a Pennsylvania workers’ comp case. The Pennsylvania Workers’ Compensation Act is a complicated piece of legislation. As loyal readers of our blog know, this is a frequent topic of cases decided by the appellate courts in PA. Trusting a workers’ compensation case to an attorney not experienced in that area of law is akin to having an orthopedist handle your coronary artery bypass surgery. Just not a good idea.

A work-related injury can cause tremendous disruption, and loss, to both the injured worker and his and her family; we are thrilled that in the near future, that injured worker can have the confidence that he or she is selecting a “certified workers’ compensation attorney.” We, of course, look forward to becoming “certified workers’ compensation attorneys” as soon as the process for the testing and certification is completed.

September 23, 2010

Compromise & Release Settlement in PA Workers’ Comp Not Enforceable Until Granted by Workers’ Compensation Judge

by Glenn Neiman

When an injured worker in PA wants to settle his or her Pennsylvania workers’ compensation claim in exchange for a lump sum of money, the process generally used is the “Compromise & Release Agreement.” This type of workers’ comp settlement is voluntary between the parties. A Compromise & Release can only take place when agreed to by both the injured worker and the PA workers’ comp insurance carrier.

As we have noted in a previous blog entry, a Compromise & Release Agreement is not final until it is actually approved by a Workers’ Compensation Judge (WCJ). The law requires that a WCJ determine whether the injured worker understands and accepts the terms and conditions of the Compromise & Release Agreement. Until the approval of the WCJ is obtained, either party may back out of the Agreement.

The limits of this theory were recently tested before the Commonwealth Court of Pennsylvania in the case of McKenna v. Workers’ Compensation Appeal Board (SSM Industries, Inc. and Liberty Mutual Insurance Co.). In this case, the parties agreed to settlement terms at a mediation (a settlement conference with a WCJ, usually not the WCJ hearing the case). A Compromise & Release Agreement was signed by both parties.

January 13, 2010

Workers’ Compensation Settlement Tough Call in PA

by Glenn Neiman

From our blog, and our presence in the community, we receive many questions regarding workers’ compensation in Pennsylvania. Just recently, someone sent us an e-mail asking, “Is it a good idea to settle a case?”

Like many aspects of law, there is no easy answer to this question. Settling a workers’ compensation case in PA is a complicated issue. Frequently, there are good reasons to settle a case, and good reasons to wait. Only a discussion of the injured worker’s exact situation provides an answer in each person’s case. Facts in every case are different, as are the injured workers involved.

Even once an injured worker decides that settling the workers’ comp case is the way to go, questions remain. How much is the case worth? Will the medical treatment stay open, even for a short period of time? Will a resignation or release be necessary? Is a Workers’ Compensation Medicare Set-Aside (WCMSA) needed? These and other questions must be addressed as the parties negotiate a settlement.